Maryanne is a 26-year-old female who is in therapy for obsessive compulsive disorder.
Mary Anne is a 26-year-old female who is in therapy for obsessive compulsive disorder. She was trialed on SSRI therapy without remission, and was changed to clomipramine, 25 mg q.h.s. titrated up to 100 mg q.h.s. 2 weeks ago. She presents today for follow up. According to the side effect profile of clomipramine, the PMHNP assesses Mary Anne’s risk for sedation, orthostatic hypotension, constipation, urinary retention, priaprism, and photosensitization/discoloration of skin and mucous membranes:
Maryanne is here today with her husband, Martin. She came to see us two weeks ago because of OCD, but we are not seeing any improvement in her symptoms. Her intake shows that she has only been on clomipramine for 2 weeks, but we should remember that because they don’t start working until at least 4 to 6 weeks, it could be another 2 to 3 weeks before she starts feeling better. Maryanne also told me that the medication makes her very anxious and shaky.
Since starting clomipramine, Maryanne has had difficulty initiating and sustaining sleep (F40.3), bruxism (715.6), agitation (333.82), dizziness (R52.4) and diarrhea (574.3).
Neutropenia, nausea, headaches, dry mouth, agitation (p. 373)
Nausea and vomiting, Sore throat, Flu-like symptoms, Dry mouth, Blurred vision, Dizziness
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Dry mouth; difficulty swallowing; blurred vision; urinary retention; constipation; drowsiness; weight gain
Decreased libido, nausea, insomnia, headache
Affective:Anxiety, Nervousness, Panic, Agitation, Insomnia, Paranoia
Blurry Vision; Constipation; Diarrhea; Dry mouth.
Maryanne is a 26-year-old female who is in therapy for obsessive compulsive disorder. She was trialed on SSRI therapy without remission and was changed to clomipramine, 25 mg q.h.s. titrated up to 100 mg q.h.s. 2 weeks ago. She presents today for follow up. The PMHNP assesses for which of the following adverse effects?